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Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined. Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23- 90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.73 times. Duration of hospitalization, requirement of intensive care and hospital mortality were similar in hypokalemia and normokalemia patients. Conclusion: In patients with Covid-19 pneumonia, hypokalemia has been found to be quite common as high as 16.8% at the first presentation. Hypokalemia was related to metabolic alkalosis but unrelated to the duration of hospitalization, requirement of intensive care including mechanical ventilation and hospital mortality. [ABSTRACT FROM AUTHOR]

Microplastics (MPs) are ubiquitous anthropogenic contaminants, and their abundance in the entire ecosystem raises the question of how far is the impact of these MPs on the biota, humans, and the environment. Recent research has overemphasized the occurrence, characterization, and direct toxicity of MPs; however, determining and understanding their genotoxic effect is still limited. Thus, the present review addresses the genotoxic potential of these emerging contaminants in aquatic organisms and in human peripheral lymphocytes and identified the research gaps in this area. Several genotoxic endpoints were implicated, including the frequency of micronuclei (MN), nucleoplasmic bridge (NPB), nuclear buds (NBUD), DNA strand breaks, and the percentage of DNA in the tail (%Tail DNA). In addition, the mechanism of MPs-induced genotoxicity seems to be closely associated with reactive oxygen species (ROS) production, inflammatory responses, and DNA repair interference. However, the gathered information urges the need for more studies that present environmentally relevant conditions. Taken into consideration, the lifestyle changes within the COVID-19 pandemic, we discussed the impact of the pandemic on enhancing the genotoxic potential of MPs whether through increasing human exposure to MPs via inappropriate disposal and overconsumption of plastic-based products or by disrupting the defense system owing to unhealthy food and sleep deprivation as well as stress. Overall, this review provided a reference for the genotoxic effect of MPs, their mechanism of action, as well as the contribution of COVID-19 to increase the genotoxic risk of MPs. [Display omitted] • The genotoxic effects of MPs are determined in somatic cells of aquatic organisms and human peripheral lymphocytes. • The mechanism of MPs-induced genotoxicity is associated with oxidative stress, inflammation, and DNA repair disruption. • The COVID-19 pandemic contributes to the genotoxic potential of MPs. [ABSTRACT FROM AUTHOR]

COVID-19 has been recognized to become a worldwide health concern at an alarming rate over time and to be more progressive and fatal in specific risk populations. This study aims to determine the clinical features of COVID-19 in kidney transplant recipients (KTRxs) and contribute to the regulation of these patients' immunosuppressive treatments and COVID-19 treatment protocols. The trial comprised eleven KTRxs with COVID-19. Immunosuppressive treatments such as antimetabolite cessation, calcineurin inhibitor dosage adjustments based on blood levels, and low-dose corticosteroids were all controlled. All patients received antiviral medication and low-molecular-weight-heparin (LMWH) as part of initial treatment. The steroid dose was then raised, and anti-cytokine therapies were provided in the setting of clinical worsening. The mean age of the patients was 50.3±11.2 years and 8 (73%) of them were male. The average time since transplantion was 6.82±3.34 years. Due to COVID-19 progression, the steroid dosage was raised in eight patients, anakinra and tocilizumab was added in five and one of the patients respectively. In five (%45) patients, the need for critical care arose and plasmapheresis was used in three of them. At the end of the follow-up, nine of our patients had made a complete recovery, whereas two (18.2%) had perished. Consistent with the literature, the data in presented study may also support the severe and fatal course of COVID-19 in KTRxs. It may be proposed that KTRxs with COVID-19 should be admitted to the hospital and constantly monitored, and certain effective management techniques should be initiated early depending on clinical circumstances. [ABSTRACT FROM AUTHOR]

Giriş: Koronavirüs hastalığı-2019 (COVID-19) pandemisi sırasında tüm dünyada yoğun bakım ünitesinde (YBÜ) tedavi ve izlem gerektiren hasta sayısında ciddi artış yaşandı. Kateter-ilişkili üriner sistem enfeksiyonları (Kİ-ÜSE), sağlık bakım ilişkili enfeksiyonlar (SBİE) arasında en sık görülmekte ve yaklaşık %75’i katetere bağlı gelişmektedir. Kİ-ÜSE’nin önlenmesi için alınan önlemler, sıklığını, morbidite ve mortalite oranlarını azaltmaktadır. Bu çalışmada, COVID-YBÜ ve genel-YBÜ’de yatarken Kİ-ÜSE gelişen hastaların demografik özellikleri, enfeksiyon hızı, risk faktörleri ve etken dağılımlarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmada, 01.04.2020-31.12.2021 tarihleri arasında bir şehir hastanesinin COVID-YBÜ ve genel-YBÜ’de yatan hastalarda yatışının 3. günü veya daha sonra ortaya çıkan ve başvuru esnasında inkübasyon döneminde olmayan tanı almış Kİ-ÜSE’ler, aktif sürveyans verileri ve Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Rehberi doğrultusunda incelendi. Birden fazla Kİ-ÜSE tanısı alan hastalarda ilk atak çalışmaya dahil edildi. Hastalar COVID-YBÜ’de ve genel YBÜ’de yatan hastalar olarak iki gruba ayrıldı; enfeksiyon hızı, risk faktörleri ve etken dağılımları açısından karşılaştırıldı. Tanımlayıcı istatistikler ortalama, medyan, IQR (interquartile range), standart sapma, minimum ve maksimum değerleri analiz edildi. Kategorik değişkenler için ki-kare testi, normal dağılıma uymayan veriler için Mann-Whitney U testi yapıldı. İstatistiksel anlamlılık düzeyi p<0,05 kabul edildi. Bulgular: Toplam 1205 yatak kapasiteli ve 224 YBÜ yatağı olan hastanemizde; 57 yataklı COVID-YBÜ, toplam 7 ünitede 77 yataklı genel üçüncü düzey erişkin YBÜ’leri mevcuttur. Çalışma döneminde genelYBÜ’de yatan 5485 hasta ve COVID-YBÜ’de yatan 1997 hasta Kİ-ÜSE açısından değerlendirildi. Genel-YBÜ’de 26 hasta, COVID-YBÜ’de 7 hasta Kİ-ÜSE tanısı aldı. Enfeksiyon hızı ve enfeksiyon dansitesi her iki tür YBÜ’de benzerdi (Tablo 1). Kİ-ÜSE tanılı hastaların demografik ve klinik özellikleri Tablo 2’de özetlenmiştir. YBÜ kabulden Kİ-ÜSE tanısı alana kadar geçen süre ve YBÜ yatış süresi, COVID-YBÜ’de anlamlı olarak daha kısaydı. En sık izole edilen Kİ-ÜSE etkenleri genel-YBÜ’de Klebsiella pneumoniae (%38,5), Pseudomonas aeruginosa (%34,6), COVID-YBÜ’de Klebsiella pneumoniae (%28,6), Pseudomonas aeruginosa (%14,3) idi. Etken dağılımları Tablo 3’te verilmiştir. Sonuç: Her iki YBÜ’de de Kİ-ÜSE, 2020 yılı Ulusal Hastane Enfeksiyonları Sürveyans Ağı ağırlıklı genel ortalaması olan %1,2’nin altındadır. YBÜ’ye yatıştan Kİ-ÜSE tanısı alana kadar geçen süre COVID-YBÜ’de daha kısadır. Sürveyans çalışmalarının Kİ-ÜSE’nin önlenmesi ve sıklığının azaltılmasındaki yeri büyüktür. Enfeksiyon kontrol programı ve Kİ-ÜSE önlem stratejilerinden önlem paketi (bundle) uygulamasına devam edilmesi önemlidir. [ABSTRACT FROM AUTHOR]